Provider Demographics
NPI:1073500856
Name:YOUNG, MARK P (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:P
Last Name:YOUNG
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:7800 SW 87TH AVE
Mailing Address - Street 2:SUITE C-340
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3570
Mailing Address - Country:US
Mailing Address - Phone:305-595-0109
Mailing Address - Fax:305-595-7092
Practice Address - Street 1:7800 SW 87TH AVE
Practice Address - Street 2:SUITE C-340
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3570
Practice Address - Country:US
Practice Address - Phone:305-595-0109
Practice Address - Fax:305-595-7092
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-05
Last Update Date:2012-07-12
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Provider Licenses
StateLicense IDTaxonomies
FLME0046002207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL056261100Medicaid
FL056261100Medicaid
FLE21397Medicare UPIN